To the Editor: In their article recently published in the Journal of the American Geriatrics Society,1 Vidan et al. demonstrated that an early multidisciplinary geriatric intervention reduces in-hospital mortality in elderly patients with hip fracture, without a significant effect on length of hospital stay. We want to contribute to this topic by presenting data from a cohort of 819 patients admitted over a 3-year period (2000–02) in the orthopedic ward of the Galliera Hospital (Genoa, Italy) and managed on an alternate annual basis with a traditional approach or an orthogeriatric care model. In 2001, an orthogeriatric service was experimentally introduced in the orthopedic unit. The service provided a comprehensive multidisciplinary evaluation of elderly patients with hip fracture at admission and daily intervention for medical management. A geriatrician was responsible for medical care, and an orthopedic surgeon was responsible for fracture management, operative decision, and discharge. The rehabilitation began during hospital stay and continued after discharge through home services or institutional facilities. The experimental phase ended after 1 year, and only recently has the orthogeriatric care been included as a permanent service of the hospital. Using administrative data sources and medical record review, length of hospital stay and in-hospital mortality of the elderly patients admitted with hip fractures in the year before (control group 1) and in the year after (control group 2) the orthogeriatric intervention were compared. Only patients aged 70 and older were considered. Telephone interview and statewide administrative database were used to ascertain 1-year mortality. The groups were compared using analysis of variance or chi-square tests. Survival data were analyzed using the Wilcoxon-Gehan statistics in the life-tables option in SPSS, version 13.0 (SPSS Inc., Chicago, IL). There were 272 subjects in the control 1 group, 252 in the intervention group, and 295 in the control 2 group. The groups were similar with regard to mean age ± standard deviation (84.0±6.8, 83.6±6.6, and 84.5±6.7, respectively, P=.21), the proportion of men (23.4%, 18.5%, 21.6%, P=.21), and length of stay (21±13 days, 21±11 days, 19±13 days, P=.16). The rate of in-hospital mortality for the intervention group was lower than for control 1 (4.8% vs 9.9%, P=.03) and similar to that of control 2 (6.8%, P=.34). Long-term mortality is shown in Figure 1. The comparison of survival curves showed a significant difference over time (P=.04), and at the end of follow-up, the survival rate was about 10% higher in the intervention group than in the control groups (75% vs 64.7% (control 1), P=.01 and vs 66.7% (control 2), P=.04). Survival curves of patients in the intervention group and the two control groups defined in the text. The P-value represents the global comparison of the three curves. Intervention group versus control 1, P=.01; intervention group versus control 2, P=.04; control 1 versus control 2, P=.55. The current data support findings from Vidan et al. 1 that demonstrated a significant reduction in in-hospital mortality with an early intensive geriatric intervention in older patients with hip fracture. Even if it is not possible to ascertain whether the involvement of the geriatric teams and the organization of the interventions were comparable, the data appear to support the hypothesis that the geriatric intervention reduces incidence and leads to better clinical management of major in-hospital complications that reduce early mortality. Moreover, a long-term survival benefit was found, whereas Vidan et al. obtained only a nonsignificant trend, probably because they had fewer subjects. It is possible that geriatric intervention may affect 1-year mortality through comprehensive assessment and global intervention for all active problems of elderly patients. In fact, a strong correlation has been demonstrated between the presence of active clinical issues on discharge and mortality.2 The current study failed to demonstrate a reduction in length of stay, even though many patients had a long hospital stay because of the wait to move from the hospital to rehabilitation services (home and institutional). Thus, nonmedical reasons largely affected total length of stay, and it is likely that subanalyses would be needed to evaluate the influence of a geriatric intervention. There are increasing data to support combined orthogeriatric care for older people with hip fracture even if not all published reports are consistent,3 although strong evidence derived from large randomized trials is needed in support of this model of care. Financial Disclosure: This letter had no financial support. Author Contributions: Antonella Barone: data management, interpretation of the data, and preparation of manuscript. Andrea Giusti: acquisition and interpretation of data and critical review. Monica Pizzonia and Monica Razzano: acquisition of data and literature search. Ernesto Palummeri: study concept and design. Giulio Pioli: study concept and design, analysis and interpretation of data, preparation of manuscript, and critical review. Sponsor's Role: None.